• 제목/요약/키워드: Pulmonary gas exchange

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Computer Models on Oxygenation Process in the Pulmonary Circulation by Gas Diffusion

  • Chang, Keun-Shik;Bae, Hwang
    • International Journal of Vascular Biomedical Engineering
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    • 제4권1호
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    • pp.9-16
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    • 2006
  • In this article we introduce computer models that have been developed in the past to determine the concentration of metabolic gases, the oxygen and carbon dioxide, along the pulmonary circulation. The terminal concentration of these gases in the arterial blood is related with the total change of the partial pressure of the same gases in the alveoli for the time beginning with inspiration and ending with expiration. It is affected not only by the ventilation-perfusion ratio and the gas diffusion capacity of the lung membrane but also by the pulmonary defect such as shunt, dead space, diffusion impairment and ventilation-perfusion mismatch. Some pathological pulmonary symptoms such as ARDS and CDPD can be understood through the mathematical models of these pulmonary dysfunctions. Quantitative study on the blood oxygenation process using various computer models is therefore of foremost importance in order to monitor not only the pulmonary health but also the cardiac output and cell metabolism. Reviewed in this paper include the basic and advanced methods that enable numerical study on the gas exchange and on the arterial oxygenation process, which might depend on the various heart and lung physiological conditions listed above.

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코일 색전술로 치료된 다발성 폐동정맥기형 1 예 (A Case of Multiple Pulmonary Arteriovenous Malformation Treated with Coil Embolization)

  • 안혁수;이흥범;이용철;이양근
    • Tuberculosis and Respiratory Diseases
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    • 제45권4호
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    • pp.896-901
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    • 1998
  • Pulmonary arteriovenous malformation(PAVM) is an uncommon congenital anomaly. As pulmonary arteriovenous malformation is a direct communication between the branches of pulmonary artery and vein which originated from the malformation of capillary development, major disturbances in gas exchange can result. This malformation results in the several symptoms such as dyspnea, hemopyssis, cyanosis, and severe neurologic complaints. However, the most of patients are usually asymptomatic. Selective pulmonary angiography is well known the helpful diagnostic method. Recently, therapeutic embolization has been advocated as the treatment of choice for pulmonary arteriovenous malformations. We report a case of multiple pulmonary arteriovenous malformation, which was detected on the simple chest X-ray and successfully treated with coil embolization in a 19-year-old asymptomatic woman.

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만성 폐색성 폐질환자를 위한 호흡재활 프로그램 개발 및 효과에 관한 연구 (The Study on the Effects of a Respiratory Rehabilitation Program for COPD Patients)

  • 김애경
    • 대한간호학회지
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    • 제31권2호
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    • pp.257-267
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    • 2001
  • It is known that a pulmonary rehabilitation program improves dyspnea and exercise tolerence in patients with chronic obstructive pulmonary disease. However, it is also known that although it does not improve pulmonary function. This study was performed to evaluate the effect of a 4 week pulmonary rehabilitation on pulmonary function, gas exchange, and exercise tolerance in patients with chronic obstructive pulmonary disease. The pulmonary rehabilitation programs included breathing exercises, such as pursed-lip breathing and diaphragmatic breathing, upper-limb exercises, and inspiratory muscle training. These activities were performed for 4 weeks in twenty one patients with chronic obstructive pulmonary disease. Pre and post-rehabilitation pulmonary function and exercise capacities were compared after the 4 week period. Results are as follows: 1) Before the rehabilitation, the predicted value of FVC and FEV1 of the patients were 70.3$\pm$16.7% and 41.1$\pm$11.9% respectively. These pulmonary functions did not change after pulmonary rehabilitation. 2) Aloility of walking a 6 minute distance (325.29$\pm$122.24 vs 363.03$\pm$120.01 p=.01) and dyspnea (p=.00) were significantly improved after rehabilitation. Thus showing that pulmonary rehabilitation for 4 weeks can improve exercise performance and dyspnea in patients with chronic obstructive pulmonary disease.

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Pulmonary Fibrosis caused by Asbestos Fibers in the Respiratory Airway

  • Jung, Ji-Woo;Kim, Eung-Sam
    • 대한의생명과학회지
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    • 제27권3호
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    • pp.111-120
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    • 2021
  • Asbestos products had been widely used until 2007 in Korea since the 1930s. A total ban on their production and applications has been imposed because of the toxic effect of asbestos fibers on the human health. The inhaled asbestos fibers increase reactive oxygen species and inflammatory reactions in the respiratory airway including the alveolar sac, resulting in DNA damages and secretion of several inflammatory cytokines or chemokines. These paracrine communications promote the proliferation of fibroblasts and the synthesis of collagen fibers, thereby depositing them into the extracellular matrix at the interstitial space of alveoli. The fibrotic tissue hindered the gas exchange in the alveolus. This reviews describes not only the cytotoxic effects of asbestos fibers with different physical or chemical characteristics but also the interaction of cells that make up the respiratory airway to understand the molecular or cellular mechanisms of asbestos fiber-induced toxicity. In addition, we propose a pulmonary toxicity research technique based on the mini-lung that can mimic human respiratory system as an alternative to overcome the limitations of the conventional risk assessment of asbestos fibers.

서울 지하철 내 공기 중 먼지의 특성에 관한 연구 (A study on Characteristics of Airborne Dusts in Seoul Subway Stations)

  • 김진경;백남원
    • 한국환경보건학회지
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    • 제30권2호
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    • pp.154-160
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    • 2004
  • The purpose of this study was to evaluate airborne concentrations and characteristics of TSP, IPM, TPM and RPM in Seoul subway stations. Sampling was performed at 14 stations from April 11 to 29, 2002. Size-selective dust concentrations and metal concentrations were measured by gravimetric method and ICP-AES, respectively. The geometric mean of TSP, IPM, TPM and RPM concentrations in Seoul subway stations were 176$\mu\textrm{g}$/㎥, 348$\mu\textrm{g}$/㎥, 158$\mu\textrm{g}$/㎥ and 104$\mu\textrm{g}$/㎥, respectively. Dust concentrations in pathway were the highest and those in lobby were the lowest. The size distribution of dusts was significantly different by location of collection. When the deposition rate into pulmonary gas exchange region was estimated by size distribution, the deposition rate of dust collected from platform was higher than those of dust collected from lobby and pathway. The lower the basement levels were, the higher the deposition rates of dusts into tracheobronchial region and gas exchange region were. Copper and iron concentrations measured in platform higher were than those in other areas.

Lung Organoid on a Chip: A New Ensemble Model for Preclinical Studies

  • Hyung-Jun Kim;Sohyun Park;Seonghyeon Jeong;Jihoon Kim;Young-Jae Cho
    • International Journal of Stem Cells
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    • 제17권1호
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    • pp.30-37
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    • 2024
  • The lung is a complex organ comprising a branched airway that connects the large airway and millions of terminal gas-exchange units. Traditional pulmonary biomedical research by using cell line model system have limitations such as lack of cellular heterogeneity, animal models also have limitations including ethical concern, race-to-race variations, and physiological differences found in vivo. Organoids and on-a-chip models offer viable solutions for these issues. Organoids are three-dimensional, self-organized construct composed of numerous cells derived from stem cells cultured with growth factors required for the maintenance of stem cells. On-a-chip models are biomimetic microsystems which are able to customize to use microfluidic systems to simulate blood flow in blood channels or vacuum to simulate human breathing. This review summarizes the key components and previous biomedical studies conducted on lung organoids and lung-on-a-chip models, and introduces potential future applications. Considering the importance and benefits of these model systems, we believe that the system will offer better platform to biomedical researchers on pulmonary diseases, such as emerging viral infection, progressive fibrotic pulmonary diseases, or primary or metastatic lung cancer.

건강폐하측위 및 흉부타진 요법이 의식저하 환자의 폐가스교환에 미치는 영향 (Effect of lateral position and chest percussion on pulmonary gas exchange in decreased level of conscious patients)

  • 서성순;소희영
    • 대한간호학회지
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    • 제21권2호
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    • pp.204-217
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    • 1991
  • The purpose of this study is to verify the effect of lateral position and chest percussion on gas exchange in the decreased level of conscious patients. The Subjects for this study were 21 patients' admitted in ICU of CNUH from Dec 18th, 1989 to Aug 4th, 1990. The Data was analyzed by paired t - test. The results of this study as follows ; 1) In comparison of supine position, good -lung dependent position and good - lung dependent with chest percussion, the difference of PaO ㆍ was statistically significant (P<0.05). 2) In comparison of supine position, good -lung dependent position and good - lung dependent with chest percussion, the difference of A-a Do ㆍ was statistically significant (p<0.05). En conclusion, the use of good -lung dependent position and chest percussion was effective nursing intervention on decreased level of conscious patients in ICU.

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만성폐쇄성폐질환의 병태생리 (Pathophysiology of Chronic Obstructive Pulmonary Disease)

  • 김현국;이상도
    • Tuberculosis and Respiratory Diseases
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    • 제59권1호
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    • pp.5-13
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    • 2005
  • COPD는 비가역적인 기류제한을 특징으로 하는 질병의 상태이다. 이러한 기류제한은 유해입자나 가스등에 대한 폐의 비정상적인 염증반응과 관련되어 있고 자연경과 중 지속적으로 진행하는 양상을 띤다. 비정상적인 염증반응 및 단백분해효소와 항단백분해효소간의 불균형과 산화 스트레스 등의 기전에 의해 점액의 과분비, 섬모의 기능장애, 소기도의 섬유화와 협착, 폐실질의 파괴, 폐혈관손상 등이 발생한다. 이러한 병리학적 변화에 의해 기류제한이 발생하고 가스교환 장애, 폐고혈압, 폐성심, 전신적인 염증이나 골격근의 기능장애 등이 유발된다. COPD 환자의 일반적인 증상인 기침, 객담, 호흡곤란 등은 이러한 병태생리학적 변화로 설명할 수 있다.

급성호흡곤란증후군 환자에서 복와위(prone position)와 산화질소흡입(nitric oxide inhalation) 병용 치료의 효과 (The Combined Therapy of Inhaled Nitric Oxide and Prone Positioning Has an Additive Effect on Gas Exchange and Oxygen Transport in Patients with Acute Respiratory Distress Syndrome)

  • 고윤석;임채만;이기만;진재용;심태선;이상도;김우성;김동순;김원동
    • Tuberculosis and Respiratory Diseases
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    • 제45권6호
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    • pp.1223-1235
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    • 1998
  • 연구배경 : 급성호흡곤란증후군(ARDS) 환자의 폐 산소화를 개선시키기 위한 보조적 치료법인 복와위 자세에서의 인공환기는 대상 환자의 약 61%에서, 흡입 산화질소 투여는 60-80%에서 효과가 있는 것으로 보고되어 있다. 산소화 호전의 주된 기전은 복와위시는 이환이 심한 등쪽 폐의 환기 호전에 의한 단락 감소이며, 산화질소 투여 시는 이환부위로부터 정상 폐포로의 폐 혈류의 재분포에 의한 단락 감소안 것으로 알려져 있다. 그러므로 복와위와 산화질소의 병용 치료 시 산소화 개선에 상승 효과를 기대할 수 있으나 이에 관한 임상 연구는 없었다. 이에 저자들은 ARDS환자에서 두 치료의 병합이 가스 교환 및 혈류 역학에 미치는 영향을 관찰하였다. 방 법 : ARDS 환자 12명(연령 $56{\pm}12$ 세, 남 : 여=9 : 3)을 대상으로 앙와위에서 호흡 및 혈류역학적 지표를 측정한 후 복와위로 전환하였다. 복와위 30분과 2시간에 동일 지표들을 측정한 뒤 산화질소를 투여하고 (5-10 ppm), 이후 30분, 2 시간 및 산화질소 투여 중단 후 10분에 각각 동일 지표들을 재 측정하였다. 결 과 : 가스 교환 지표 : 복와위에서 산화질소 병용 치료시, 앙와위 및 복와위에서보다 $PaO_2/FiO_2$가 증가되었고(각각 p< 0.01) 폐동맥혈 산소분압차($AaDO_2$)는 감소하였다(각각 p<0.005). 호흡 역학적 지표 : 폐 탄성, 호흡기계 탄성, 기도 저항 및 흡기말 기도압은 치료 방법에 따른 차이가 없었다. 혈류 역학적 지표 : 복와위에서 산화질소 병용 치료시, 앙와위 및 복와위에서보다 심 박출량 및 조직산소전달량($DO_2$)이 증가되었으며(각 P< 0.05), 폐혈관 저항, 평균 폐동맥압 및 폐동맥쐐기압은 감소되었다(각 P< 0.05). 결 론 : 급성호흡곤란증후군 환자에서 복와위 및 산화질소 홉업의 병용 치료는 복와위 단독 치료에 비해 폐산소화 호전에 상승 작용이 있으며, 조직으로의 산소 전달량도 증가시키므로 급성호흡곤란증후군 환자의 보조적인 치료법으로써 유용할 것으로 사료되었다.

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만성폐쇄성폐질환 환자에서 골격근 기능 이상 (Skeletal Muscle Dysfunction in Patients with Chronic Obstructive Pulmonary Disease)

  • 김호철;이기동;황영실
    • Tuberculosis and Respiratory Diseases
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    • 제68권3호
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    • pp.125-139
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    • 2010
  • Patients with chronic obstructive pulmonary disease (COPD) frequently complain of dyspnea on exertion and reduced exercise capacity, which has been attributed to an increase in the work of breathing and in impaired of gas exchange. Although COPD primarily affects the pulmonary system, patients with COPD exhibit significant systemic manifestations of disease progression. These manifestations include weight loss, nutritional abnormalities, skeletal muscle dysfunction (SMD), cardiovascular problems, and psychosocial complications. It has been documented that SMD significantly contributes to a reduced exercise capacity in patients with COPD. Ventilatory and limb muscle in these patients show structural and functional alteration, which are influenced by several factors, including physical inactivity, hypoxia, smoking, aging, corticosteroid, malnutrition, systemic inflammation, oxidative stress, apoptosis, and ubiquitin-proteasome pathway activation. This article summarizes briefly the evidence and the clinical consequences of SMD in patients with COPD. In addition, it reviews contributing factors and therapeutic strategies.